Citation Nr: 1340095 Decision Date: 12/05/13 Archive Date: 12/20/13 DOCKET NO. 10-22 469 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to an initial compensable disability rating for eczema. REPRESENTATION Appellant represented by: Georgia Department of Veterans Services ATTORNEY FOR THE BOARD M. Harrigan Smith, Counsel INTRODUCTION The Veteran had active service from February 1980 to June 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2008 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO), in Atlanta, Georgia, that, in pertinent part, granted service connection for eczema of the bilateral feet and ankles, rated as noncompensable as of July 1, 2007. The Veteran expressed disagreement with the assigned initial disability rating and perfected a substantive appeal. On the May 2010 Appeal To Board Of Veterans' Appeals (VA Form 9), the Veteran requested a hearing before a Veterans Law Judge of the Board to be held in Washington, DC. He was scheduled for the requested hearing in September 2013; however, as he did not report at the scheduled time and has not provided good cause for his absence, his hearing request is deemed withdrawn. 38 C.F.R. § 20.702(d) (2013). In addition to the paper claims file, there is a Virtual VA paperless claims file associated with the Veteran's claim. A review of the documents in such file reveals that they are either duplicative of the evidence in the paper claims file or are irrelevant to the issue on appeal. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND Unfortunately, a remand is required in this case. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. VA has a duty to make reasonable efforts to assist the claimant in obtaining evidence necessary to substantiate the claim for the benefit sought, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. 38 U.S.C.A. § 5103A(a) (West 2002 & Supp. 2012); 38 C.F.R. § 3.159(c), (d) (2013). Service connection is in effect for eczema of the bilateral feet and ankles (claimed as lesions and rash), rated as noncompensable as of July 1, 2007. The Veteran's service-connected skin disability is rated under Diagnostic Code 7806, which provides the rating criteria for dermatitis or eczema. Diagnostic Code 7806 provides that a noncompensable disability rating is warranted for dermatitis or eczema that involves less than 5 percent of the entire body or less than 5 percent of exposed areas affected, and no more than topical therapy is required during the past 12-month period. A 10 percent disability rating is warranted for dermatitis or eczema that involves at least 5 percent, but less than 20 percent, of the entire body, or at least 5 percent, but less than 20 percent, of exposed areas affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. A 30 percent disability rating is assigned where 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas are affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs is required for a total duration of six weeks or more, but not constantly, during the past 12-month period. The maximum 60 percent disability rating is assigned when more than 40 percent of the entire body or more than 40 percent of exposed areas are affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs is required during the past 12- month period. 38 C.F.R. § 4.118 , Diagnostic Code 7806 (2013). The Veteran was afforded VA skin examinations in November 2007, January 2009, and October 2012 so as to determine the severity of his service-connected skin disability. These examination reports appear to have been limited to eczema involving the feet and ankles. However, in the May 2010 VA Form 9, the Veteran indicated that in addition to both feet, his service-connected eczema affects his neck, back, both legs, groin area, and face. As such, the Board finds that the Veteran must be scheduled for another examination, preferably during a period of recurrence, so as to assess the precise nature and severity of the Veteran's eczema that is now said to be affecting his neck, back, both legs, groin area, and face. When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213 (1992). See also Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007) (once VA provides an examination to a Veteran, VA has a duty to ensure that the examination is adequate for evaluation purposes); Hicks v. Brown, 8 Vet. App. 417, 422 (1995) (inadequate medical evaluation frustrates judicial review); Ardison v. Brown, 6 Vet. App. 405, 407 (1994) (when a claimant's medical history indicates that his condition undergoes periods of remission and recurrence, VA is required to provide a medical examination during the period of recurrence in order to provide a proper disability rating.). Finally, as this matter is being remanded for the reasons set forth above, any additional VA treatment records of the Veteran for his asserted disability should also be obtained. See 38 U.S.C.A. § 5103A(b), (c); 38 C.F.R. § 3.159(b); see also Bell v. Derwinski, 2 Vet. App. 611 (1992) (VA medical records are in constructive possession of the agency, and must be obtained if the material could be determinative of the claim). Accordingly, the case is REMANDED for the following action: 1. The RO/AMC shall take appropriate steps to contact the Veteran and request that he identify all VA and non-VA health care providers, other than those already associated with the Veteran's claims file, that have treated him for his claimed disability. This shall specifically include updated treatment records from VA. The aid of the Veteran in securing these records, to include providing necessary authorization(s), should be enlisted, as needed. If any requested records are not available, or if the search for any such records otherwise yields negative results, that fact should clearly be documented in the claims file, and the Veteran informed in writing. The Veteran may submit medical records directly to VA. 2. The RO/AMC shall schedule the Veteran for a VA skin disorders examination to determine the current severity of his service-connected eczema. To the extent possible, the examination should be undertaken during an ACTIVE stage of the disability. The claims file, including a complete copy of this remand, must be made available to the designated examiner for a review of the Veteran's pertinent medical history. All necessary testing and evaluation should be completed. The examiner is advised that the Veteran has asserted that his service-connected eczema affects both feet, neck, back, both legs, groin area, and face. The examiner must make specific clinical findings in assessing the Veteran's service-connected eczema, to specifically include all body parts affected by the disability: (i) the percentage of the entire body that is affected; (ii) the percentage of the exposed areas of the body that is affected; and (iii) whether treatment of the dermatitis requires treatment by systemic therapy, such as corticosteroids or other immunosuppressive drugs, and if so, the annual duration in weeks that is required. The examiner is also advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions. If the examiner rejects the Veteran's reports of symptomatology, he or she must provide a reason for doing so. The examiner is also asked to comment on the impact of the claimed increase in severity of the Veteran's disability, if any, on the his employment and activities of daily life. A complete rationale for any opinion expressed shall be provided. 3. The RO/AMC will then review the Veteran's claims file and ensure that the foregoing development actions have been conducted and completed in full, and that no other notification or development action, in addition to those directed above, is required. If further action is required, it should be undertaken prior to further claim adjudication. 4. The RO/AMC will then readjudicate the Veteran's claim. If the benefit sought on appeal remains denied, the Veteran and his representative shall be provided with a Supplemental Statement of the Case. An appropriate period of time should be allowed for response. Thereafter, if appropriate, the case is to be returned to the Board, following applicable appellate procedure. The Veteran need take no action until he is so informed. He has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). The purposes of this remand are to obtain additional information and comply with all due process considerations. No inference should be drawn regarding the final disposition of this claim as a result of this action. This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ DEMETRIOS G. ORFANOUDIS Acting Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2013).